SUDHANSHU PATEL MD
NPI 1104816370
Internal Medicine - Gastroenterology in St Clair Shores, MI

Q: What is Sudhanshu Patel's NPI number?

The NPI number for Sudhanshu Patel is 1104816370. It was assigned to this individual provider in the NPPES registry on October 27, 2005.

Q: What is Sudhanshu Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Sudhanshu Patel was last updated on September 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 27, 2005PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

28963 LITTLE MACK AVE, SUITE 101, ST CLAIR SHORES, MI 48081(586) 447-0700(586) 498-0707 Get Directions Write a Review

NPPES record last updated: September 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Sudhanshu Patel Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUDHANSHU PATEL MD (NPI 1104816370) is an individual gastroenterology provider in St Clair Shores, Michigan, licensed in Michigan (4301050236) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital - Grosse Pointe, and is a graduate of Wayne State University School Of Medicine (1985).

NPPES Registry Identity

NPI1104816370

Entity TypeIndividualMale

Primary Taxonomy207RG0100X

Provider Legal NameSUDHANSHU PATELCredential: MD

Location Address28963 LITTLE MACK AVE, SUITE 101St Clair Shores, MI 48081-3015

Mailing Address28963 Little Mack Ave Ste 101Saint Clair Shores, MI 48081-3017 · (586) 447-0700 · Fax (586) 447-0795

Phone(586) 447-0700

Fax(586) 498-0707

Sole ProprietorYes

Medical School CMSWayne State University School Of MedicineGraduated 1985

Enumeration DateOctober 27, 2005

Last NPPES UpdateSeptember 22, 2025

NPPES CertifiedSeptember 22, 2025

✔ NPI 1104816370 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in MI · 4301050236

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

28963 LITTLE MACK AVE, St Clair Shores, MI 48081

Open in Google Maps ↗

Other Identifiers 4

Other2383402001Cigna

Other5863128Aetna

Medicaid2666229-10MI

OtherP51267Bcn

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sudhanshu Patel Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113909060

PECOS Enrollment IDI20100814000045

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Pathology examination of tissue using a microscope, intermediate complexity 88305

A pathology examination of tissue with intermediate complexity involves studying a small sample of your body tissue under a microscope. This helps in identifying any abnormal cells or signs of disease. It's a detailed process requiring expert analysis to ensure accurate results.

334 services139 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

134 services103 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

112 services96 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

87 services87 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

63 services62 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

60 services60 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

44 services44 patients

Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231

Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.

36 services24 patients

Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221

Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.

19 services19 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

18 services18 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

17 services17 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

12 services12 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Beaumont Hospital - Grosse Pointe

Acute Care Hospitals · Grosse Pointe, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230089

Location468 Cadieux RdGrosse Pointe, MI 48230 · Wayne County

Emergency services Birthing friendly

Beaumont Hospital Royal Oak

Acute Care Hospitals · Royal Oak, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230130

Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County

Emergency services Birthing friendly

Ascension St John Hospital

Acute Care Hospitals · Detroit, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230165

Location22101 Moross RdDetroit, MI 48236 · Wayne County

Emergency services Birthing friendly

Ascension Macomb Oakland Hosp-Warren Campus

Acute Care Hospitals · Warren, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230195

Location11800 East Twelve Mile RoadWarren, MI 48093 · Macomb County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48081 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$134.28 typical visit price

range $58.04 – $177.36

Typical copayment $33.57 (range $14.51 – $44.34)

Most-billed visit code 99204

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

29%308 patients2/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%863 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

70%422 patients3/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

99%185 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.

95%196 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

29%652 patients2/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

99%196 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIANNA MICHELLE LYONS NP

Nurse Practitioner (Acute Care)

28963 LITTLE MACK AVE, 101
SAINT CLAIR SHORES, MI 48081

Macomb County (586) 447-0700

GI MEDICAL ASSOC PC

Internal Medicine (Gastroenterology)

28963 LITTLE MACK AVE, SUITE 101
SAINT CLAIR SHORES, MI 48081

Macomb County (586) 447-0700

EASTSIDE GROUP LLC

Anesthesiology

28963 LITTLE MACK AVE, SUITE 103
SAINT CLAIR SHORES, MI 48081

Macomb County (586) 447-5110

IRENA ZALEWSKA MD

Internal Medicine (Gastroenterology)

28963 LITTLE MACK AVE, GI MEDICINE ASSOCIATES PC SUITE 101
ST CLAIR SHORES, MI 48081

Macomb County (586) 447-0700

EASTSIDE ASSOCIATES, LLC

Clinic/Center (Endoscopy)

28963 LITTLE MACK AVE, SUITE 103
ST CLAIR SHORES, MI 48081

Macomb County (586) 447-5110

KETAN G RANA MD

Internal Medicine (Gastroenterology)

28963 LITTLE MACK AVE, GI MEDICINE ASSOCIATES PC SUITE 101
ST CLAIR SHORES, MI 48081

Macomb County (586) 447-0700

VALIYA V RAVI MD

Internal Medicine (Gastroenterology)

28963 LITTLE MACK AVE, GI MEDICINE ASSOCIATES PC
ST CLAIR SHORES, MI 48081

Macomb County (586) 447-0700

VASILIOS POZIOS MD

Internal Medicine (Gastroenterology)

28963 LITTLE MACK AVE, GI MEDICINE ASSOCIATES PC SUITE 101
ST CLAIR SHORES, MI 48081

Macomb County (586) 447-0700

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sudhanshu Patel's NPI number?

The NPI number for Sudhanshu Patel is 1104816370. It was assigned to this individual provider in the NPPES registry on October 27, 2005.

Where is Sudhanshu Patel located?

Sudhanshu Patel practices at 28963 Little Mack Ave Suite 101, St Clair Shores, MI 48081. The listed phone number is (586) 447-0700.

What is Sudhanshu Patel's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Sudhanshu Patel enrolled in Medicare?

Yes. Sudhanshu Patel is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Sudhanshu Patel accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list Sudhanshu Patel as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sudhanshu Patel affiliated with any hospitals?

According to CMS data, Sudhanshu Patel is affiliated with Beaumont Hospital - Grosse Pointe, Beaumont Hospital Royal Oak, Ascension St John Hospital and Ascension Macomb Oakland Hosp-Warren Campus.

When was this NPI record last updated?

The NPPES record for Sudhanshu Patel was last updated on September 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.